What is the difference between submitted, allowed, and paid amounts?

Submitted is what the provider charged. Allowed is the Medicare-approved amount for those services. Paid is what Medicare actually paid (the rest may be patient responsibility or not covered).

Does a high Medicare payment mean a provider is better?

No. Payment totals reflect billing volume and the mix of services and patients — not the quality of care. They should never be read as a quality ranking.

Where does this payment data come from?

From the CMS Medicare Physician & Other Practitioners public use files, published annually in the public domain. Each profile shows the year of the data.

Understanding Medicare provider payment data

Updated 2026-07-19

When a provider bills Medicare, those totals are published each year by CMS. We show them on the provider’s profile so you can see the scale and mix of their Medicare practice — with an important caveat up front: these numbers measure billing volume, not quality.

The three dollar figures

Submitted — the total the provider charged for their services.
Allowed — the Medicare-approved amount for those services (usually lower than submitted).
Paid — what Medicare actually paid. The gap between allowed and paid is typically patient cost-sharing.

Beneficiaries and services

Alongside the dollars, profiles show how many distinct Medicare beneficiaries a provider saw and how many services they delivered — useful context for the totals. A high-volume hospitalist and a boutique specialist can have very different numbers for reasons that have nothing to do with care quality.

Reading it responsibly

Payment data is a factual public record, not a recommendation. It won’t tell you whether a provider is right for you — only a licensed professional and your own judgment can. To explore, search for a provider or browse a specialty.

Frequently asked questions

What is the difference between submitted, allowed, and paid amounts?: Submitted is what the provider charged. Allowed is the Medicare-approved amount for those services. Paid is what Medicare actually paid (the rest may be patient responsibility or not covered).
Does a high Medicare payment mean a provider is better?: No. Payment totals reflect billing volume and the mix of services and patients — not the quality of care. They should never be read as a quality ranking.
Where does this payment data come from?: From the CMS Medicare Physician & Other Practitioners public use files, published annually in the public domain. Each profile shows the year of the data.

Informational only — not medical advice, and not affiliated with CMS, NPPES, or any government agency.